Information Collection Request
[NCEH] Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS)
ICR 202306-0920-014 · OMB 0920-1204 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 ACBS Consent and Survey - Child |
Form and Instruction | Modified | Repair queued |
| ACBS Consent and Survey - Adult |
Form and Instruction | Modified | Repair queued |
| Cellphone Screener - Child |
Form | Modified | Repair queued |
| Landline Screener - Child |
Form | Modified | Repair queued |
| Cell Phone Screener - Adult |
Form | Modified | Repair queued |
| Landline Screener - Adult |
Form | Modified | Repair queued |
 Att14 Design Oprtn NAS.pdf |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
 Att13 ACBS Smmry Data Quality Rpr.docx |
Supplementary Document | Uploaded 2023-07-05 | Missing upstream |
| Att12 ACBS Resp Rate Formulae.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att11 ACBS 2020 Response Rates.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att10 ACBS Dspstn Codes Call-back Rules.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att9 ACBS Dt Cllctn Prcss.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att8b BRFSS IRB statement.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att8a NCEH-ATSDR Research Determination Form.pdf |
Supplementary Document | Uploaded 2023-07-05 | Missing upstream |
| Att7a BRFSS 2021 Data Com.pdf |
Supplementary Document | Uploaded 2023-07-05 | Missing upstream |
| Att7 BRFSS Data Collection protocol 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Missing upstream |
| Att6d BRFSS OMB SSB 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att6c BRFSS OMB SSA 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Missing upstream |
| Att6a BRFSS Privacy Cnfdlty Protctn 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att6 2023 BRFSS Questionnaire 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Missing upstream |
| Att4 ACBS Dt Cllctn Gdlns 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att3 ListACBSAwrdeeStates 2023.docx |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att2 ACBS 2023 60D Publication.pdf |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| Att1 ACBS Authorizing Legislation 2023 Rev.pdf |
Supplementary Document | Uploaded 2023-07-05 | Repair queued |
| 1 - ACBS ListAttchmnts 2023 Rev.docx |
Supplementary Document | Uploaded 2023-07-05 | Available |
| 1 - SSB ACBS OMB 2023 Rev.docx |
Supporting Statement B | Uploaded 2023-07-05 | Repair queued |
| 1 - SSA ACBS OMB 2023 Rev_06272023.docx |
Supporting Statement A | Uploaded 2023-07-05 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 243153 |  ACBS Data Submission Layout - Child |
Other-Data Submission Layout - Child | Modified | |
| 224745 | ACBS Data Submission Layout - Adult |
Other-Data Submission Layout - Adult | Modified | |
| 224744 | ACBS Consent and Survey - Child |
Form and Instruction | Modified | |
| 224743 | ACBS Consent and Survey - Adult |
Form and Instruction | Modified | |
| 224742 | Cellphone Screener - Child |
Form | Modified | |
| 224741 | Landline Screener - Child |
Form | Modified | |
| 224740 | Cell Phone Screener - Adult |
Form | Modified | |
| 224739 | Landline Screener - Adult |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1204 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202008-0920-004 |
| Agency Tracking No | 0920-1204 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |